Cooper C J, El-Shiekh R A, Cohen D J, Blaesing L, Burket M W, Basu A, Moore J A
Medical College of Ohio, Cardiology Division, Toledo, Ohio 43699-0008, USA.
Am Heart J. 1999 Sep;138(3 Pt 1):430-6. doi: 10.1016/s0002-8703(99)70143-2.
Transradial access is a recently developed alternative for diagnostic cardiac catheterization. Its effects on quality of life after the procedure, patient preference, and cost are unknown.
We performed a randomized single-center trial in which 99 patients underwent transfemoral and 101 underwent transradial diagnostic cardiac catheterization. Quality of life was measured with the SF-36 and visual analog scales at baseline, 1 day, and 1 week. Patients were examined at 1 day and at 1 week after for complications. Costs were measured prospectively. One patient in the femoral group and 2 in the radial group crossed over to the alternative access site. There were no major access site complications. One patient in the transfemoral group had a minor stroke. Transradial catheterization significantly reduced median length of stay (3.6 vs 10.4 hours, P <.0001). Over the first day after the procedure, measures of bodily pain, back pain, and walking ability favored the transradial group (P <.05 for all comparisons). Over the week after the procedure, changes in role limitations caused by physical health, bodily pain, and back pain favored the transradial group (P <.05 for all comparisons). There was a strong patient preference for transradial catheterization as well (P <. 0001). Transradial catheterization led to significant reductions in bed, pharmacy, and total hospital costs ($2010 vs $2299, P <.0001).
Among patients undergoing diagnostic cardiac catheterization, transradial access leads to improved quality of life after the procedure, is strongly preferred by patients, and reduces hospital costs.
经桡动脉途径是最近开发的用于诊断性心脏导管插入术的一种替代方法。其对术后生活质量、患者偏好及成本的影响尚不清楚。
我们进行了一项单中心随机试验，99例患者接受经股动脉诊断性心脏导管插入术，101例患者接受经桡动脉诊断性心脏导管插入术。在基线、术后1天和1周时，用SF - 36量表和视觉模拟量表测量生活质量。术后1天和1周检查患者有无并发症。前瞻性地测量成本。股动脉组有1例患者，桡动脉组有2例患者交叉至另一种入路部位。未发生主要入路部位并发症。经股动脉组有1例患者发生轻度中风。经桡动脉导管插入术显著缩短了中位住院时间（3.6小时对10.4小时，P <.0001）。在术后第一天，身体疼痛、背痛和行走能力方面的指标有利于经桡动脉组（所有比较P <.05）。在术后一周内，由身体健康、身体疼痛和背痛导致的角色限制变化有利于经桡动脉组（所有比较P <.05）。患者对经桡动脉导管插入术也有强烈的偏好（P <.0001）。经桡动脉导管插入术使床位、药房和总住院费用显著降低（2010美元对2299美元，P <.0001）。
在接受诊断性心脏导管插入术的患者中，经桡动脉途径可改善术后生活质量，深受患者青睐，并降低医院成本。
